This is a descriptive, cross-sectional, nationally representative study to investigate the perceptions of nurse practitioners (NP) and physician assistants (PA) regarding ethical issues associated with primary care practice. With the projected trends for NPs and PAs substantially increasing, knowledge of factors that influence ethical practice and the degree of ethical conflict experienced by these professionals will be relevant in shaping the future role of the NP and PA for the provision of quality cost-effective health care. Data is being analyzed using descriptive statistics and measures of central tendency (frequencies, mean, standard deviation) as well as bivariate correlations and multivariate regression to determine factors that predict ethical conflict in practice and perceived delivery of quality care. Surveys were mailed, to 3900 NPs and PAs in the U.S. Data on ethical conflicts and impact on practice are currently being analyzed. Manuscripts are under review. A substudy was nested into the larger study to evaluate the effectiveness of monetary incentives on increasin response rates to a mailed self-administered questionnaire, subjects were randomly assigned to one of three incentive groups.